Table of Contents
Definition / general | Terminology | Epidemiology | Etiology | Clinical features | Prognostic factors | Case reports | Treatment | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Positive stains | Negative stains | Electron microscopy description | Molecular / cytogenetics description | Differential diagnosisCite this page: Jimenez R. Teratoma-neuroendocrine tumor. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/testiscarcinoid.html. Accessed October 3rd, 2023.
Definition / general
- Low grade neuroendocrine carcinoma, similar to counterpart at other sites
- Usually monomorphic cells growing in solid nests, trabeculae or pseudoglands
Terminology
- Also called pure neuroendocrine carcinoma
- Previous called carcinoid tumor, well differentiated neuroendocrine tumor
Epidemiology
- Rare ( < 1% of testicular neoplasms), mean age 46 years
Etiology
- Carcinoid tumors are neuroendocrine tumors derived from enterochromaffin (Kulchitsky) cells that secrete serotonin and most commonly arise in GI and respiratory tracts
- In testis, presumed to be a monodermal teratoma, although 20% have other teratomatous elements
Clinical features
- Only 10% have clinical carcinoid syndrome
Prognostic factors
- Metastatic disease is associated with carcinoid syndrome, tumor size 7 cm or more (Cancer 1993;72:1726)
Case reports
- 12 year old boy with nodal metastases (J Pediatr Surg 2005;40:e19)
- 25 year old man with intratubular germ cell neoplasia in surrounding tissue (J Clin Pathol 2005;58:1331)
- 41 year old man with incidental tumor found at elective sterilization (J Androl 2004;25:338)
- 76 year old man with metastatic carcinoid tumor (Arch Pathol Lab Med 1981;105:515)
Treatment
- Excision; occasionally metastasizes
Gross description
- Solid, yellowish tan, well circumscribed
- Cysts reflect other teratomatous elements
Microscopic (histologic) description
- Islands of cells forming small acini; cords forming rosettes or sheets
- Cells have granular eosinophilic cytoplasm, round nuclei with granular chromatin
- Usually no intratubular germ cell neoplasia, no / minimal mitotic activity, usually minimal atypia or necrosis
Microscopic (histologic) images
AFIP images
Images hosted on other servers:
Cytology description
- Isolated or sheets of tumor cells with granular cytoplasm, round nuclei, uniformly distributed fine chromatin
Positive stains
- Cytokeratin, chromogranin, synaptophysin, serotonin (Am J Clin Pathol 2003;120:182)
Electron microscopy description
- Neurosecretory granules
Molecular / cytogenetics description
- i(12p) (Clin Cancer Res 2008;14:1393)
Differential diagnosis
- Metastatic carcinoid to testis: usually bilateral, multifocal, vascular invasion, case report of metastasis to scrotum at Am J Clin Pathol 1991;96:664
- Sertoli cell tumor: lacks prominent cytoplasmic granularity and coarse chromatin; inhibin+